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randomised control trial Emergency medicine

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https://www.readbyqxmd.com/read/28698337/protocol-for-a-multicentre-randomised-feasibility-study-evaluating-the-impact-of-a-prognostic-model-for-management-of-blunt-chest-wall-trauma-patients-stumbl-trial
#1
Ceri Battle, Zoe Abbott, Hayley A Hutchings, Claire Oâ Neill, Sam Groves, Alan Watkins, Fiona E Lecky, Sally Jones, James Gagg, Richard Body, Philip A Evans
INTRODUCTION: A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the emergency department (ED). A definitive randomised controlled trial (impact trial) is required to assess the clinical and cost effectiveness of the new model before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28619302/chinese-herbal-medicine-for-treating-menopausal-symptoms-in-london-women-developing-a-good-practice-protocol-via-the-factor-analysis-of-prescribing-patterns-in-a-clinical-study
#2
Volker Scheid, Veronica Tuffrey, Mark Bovey
The objective of the study described in this paper was to define Chinese medicine formula patterns for the treatment of menopausal women in London. These formula patterns are intended to inform the development of best practice guidelines for a future pragmatic randomised controlled trial, with the ultimate goal of evaluating the possibility of integrating Chinese medicine treatment strategies for menopausal symptoms into the UK National Health Service. Data from a clinical study that had demonstrated the effectiveness and safety of Chinese medicine in treating 117 perimenopausal women at the Westminster University Polyclinic in London were analysed for symptom occurrence and herb use...
June 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28450467/quality-of-reporting-in-abstracts-of-rcts-published-in-emergency-medicine-journals-a-protocol-for-a-systematic-survey-of-the-literature
#3
Federico Germini, Maura Marcucci, Marta Fedele, Maria Giulia Galli, Lawrence Mbuagbaw, Valentina Salvatori, Giacomo Veronese, Andrew Worster, Lehana Thabane
INTRODUCTION: The quality of reporting of abstracts of randomised controlled trials (RCTs) in major general medical journals and in some category-specific journals was shown to be poor before the publication of the ConsolidatedStandards of ReportingTrials (CONSORT) extension for abstracts in 2008, and an improvement in the quality of reporting of abstracts was observed after its publication. The effect of the publication of the CONSORT extension for abstracts on the quality of reporting of RCTs in emergency medicine journals has not been studied...
April 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28302636/pharmacist-provided-medicines-reconciliation-within-24%C3%A2-hours-of-admission-and-on-discharge-a-randomised-controlled-pilot-study
#4
Brit Cadman, David Wright, Amanda Bale, Garry Barton, James Desborough, Eman A Hammad, Richard Holland, Helen Howe, Ian Nunney, Lisa Irvine
BACKGROUND: The UK government currently recommends that all patients receive medicines reconciliation (MR) from a member of the pharmacy team within 24 hours of admission and subsequent discharge. The cost-effectiveness of this intervention is unknown. A pilot study to inform the design of a future randomised controlled trial to determine effectiveness and cost-effectiveness of a pharmacist-delivered service was undertaken. METHOD: Patients were recruited 7 days a week from 5 adult medical wards in 1 hospital over a 9 month period and randomised using an automated system to intervention (MR within 24 hours of admission and at discharge) or usual care which may include MR (control)...
March 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28166743/molecular-point-of-care-testing-for-respiratory-viruses-versus-routine-clinical-care-in-adults-with-acute-respiratory-illness-presenting-to-secondary-care-a-pragmatic-randomised-controlled-trial-protocol-respoc
#5
Nathan J Brendish, Ahalya K Malachira, Tristan W Clark
BACKGROUND: Respiratory viruses are associated with a huge socio-economic burden and are responsible for a large proportion of acute respiratory illness in hospitalised adults. Laboratory PCR is accurate but takes at least 24 h to generate a result to clinicians and antigen-based point-of-care tests (POCT) lack sensitivity. Rapid molecular platforms, such as the FilmArray Respiratory Panel, have equivalent diagnostic accuracy to laboratory PCR and can generate a result in 1 h making them deployable as POCT...
February 6, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28076656/combined-inhaled-beta-agonist-and-anticholinergic-agents-for-emergency-management-in-adults-with-asthma
#6
REVIEW
Scott W Kirkland, Christine Vandenberghe, Britt Voaklander, Taylor Nikel, Sandra Campbell, Brian H Rowe
BACKGROUND: Inhaled short-acting anticholinergics (SAAC) and short-acting beta₂-agonists (SABA) are effective therapies for adult patients with acute asthma who present to the emergency department (ED). It is unclear, however, whether the combination of SAAC and SABA treatment is more effective in reducing hospitalisations compared to treatment with SABA alone. OBJECTIVES: To conduct an up-to-date systematic search and meta-analysis on the effectiveness of combined inhaled therapy (SAAC + SABA agents) vs...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28051764/the-use-of-fibrin-sealant-during-non-emergency-surgery-a-systematic-review-of-evidence-of-benefits-and-harms
#7
Steven J Edwards, Fay Crawford, Michelle Helena van Velthoven, Andrea Berardi, George Osei-Assibey, Mariana Bacelar, Fatima Salih, Victoria Wakefield
BACKGROUND: Fibrin sealants are used in different types of surgery to prevent the accumulation of post-operative fluid (seroma) or blood (haematoma) or to arrest haemorrhage (bleeding). However, there is uncertainty around the benefits and harms of fibrin sealant use. OBJECTIVES: To systematically review the evidence on the benefits and harms of fibrin sealants in non-emergency surgery in adults. DATA SOURCES: Electronic databases [MEDLINE, EMBASE and The Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Health Technology Assessment database and the Cochrane Central Register of Controlled Trials)] were searched from inception to May 2015...
December 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28010731/a-survey-of-facilitators-and-barriers-to-recruitment-to-the-magnetic-trial
#8
Geetinder Kaur, Rosalind L Smyth, Colin V E Powell, Paula Williamson
BACKGROUND: Recruitment to randomised controlled trials with children is challenging. It is imperative to understand the factors that boost or hinder recruitment of children to clinical trials. We conducted a survey of facilitators and barriers to recruitment to the MAGNETIC trial, using a previously developed web-based tool. METHODS: MAGNETIC is a multicentre randomised trial of nebulised magnesium in acute severe asthma, recruiting 508 children from 30 UK sites...
December 23, 2016: Trials
https://www.readbyqxmd.com/read/27873322/non-medical-prescribing-versus-medical-prescribing-for-acute-and-chronic-disease-management-in-primary-and-secondary-care
#9
REVIEW
Greg Weeks, Johnson George, Katie Maclure, Derek Stewart
BACKGROUND: A range of health workforce strategies are needed to address health service demands in low-, middle- and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals, and physician assistants substituting for doctors in a prescribing role, and this is one approach to improve access to medicines. OBJECTIVES: To assess clinical, patient-reported, and resource use outcomes of non-medical prescribing for managing acute and chronic health conditions in primary and secondary care settings compared with medical prescribing (usual care)...
November 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27855099/cluster-randomised-feasibility-trial-to-improve-the-control-of-hypertension-in-rural-india-chiri-a-study-protocol
#10
Michaela A Riddell, Rohina Joshi, Brian Oldenburg, Clara Chow, K R Thankappan, Ajay Mahal, Nihal Thomas, Velandai K Srikanth, Roger G Evans, Kartik Kalyanram, Kamakshi Kartik, Pallab K Maulik, Simin Arabshahi, R P Varma, Rama K Guggilla, Oduru Suresh, G K Mini, Fabrizio D'Esposito, Thirunavukkarasu Sathish, Mohammed Alim, Amanda G Thrift
INTRODUCTION: Hypertension is emerging in rural populations of India. Barriers to diagnosis and treatment of hypertension may differ regionally according to economic development. Our main objectives are to estimate the prevalence, awareness, treatment and control of hypertension in 3 diverse regions of rural India; identify barriers to diagnosis and treatment in each setting and evaluate the feasibility of a community-based intervention to improve control of hypertension. METHODS AND ANALYSIS: This study includes 4 main activities: (1) assessment of risk factors, quality of life, socioeconomic position and barriers to changes in lifestyle behaviours in ∼14 500 participants; (2) focus group discussions with individuals with hypertension and indepth interviews with healthcare providers, to identify barriers to control of hypertension; (3) use of a medicines-availability survey to determine the availability, affordability and accessibility of medicines and (4) trial of an intervention provided by Accredited Social Health Activists (ASHAs), comprising group-based education and support for individuals with hypertension to self-manage blood pressure...
October 8, 2016: BMJ Open
https://www.readbyqxmd.com/read/27625060/study-protocol-for-a-randomised-controlled-trial-of-invasive-versus-conservative-management-of-primary-spontaneous-pneumothorax
#11
Simon G A Brown, Emma L Ball, Kyle Perrin, Catherine A Read, Stephen E Asha, Richard Beasley, Diana Egerton-Warburton, Peter G Jones, Gerben Keijzers, Frances B Kinnear, Ben C H Kwan, Y C Gary Lee, Julian A Smith, Quentin A Summers, Graham Simpson
INTRODUCTION: Current management of primary spontaneous pneumothorax (PSP) is variable, with little evidence from randomised controlled trials to guide treatment. Guidelines emphasise intervention in many patients, which involves chest drain insertion, hospital admission and occasionally surgery. However, there is evidence that conservative management may be effective and safe, and it may also reduce the risk of recurrence. Significant questions remain regarding the optimal initial approach to the management of PSP...
September 13, 2016: BMJ Open
https://www.readbyqxmd.com/read/27502818/pregnant-women-and-health-professional-s-perceptions-of-complementary-alternative-medicine-and-participation-in-a-randomised-controlled-trial-of-acupressure-for-labour-onset
#12
RANDOMIZED CONTROLLED TRIAL
Lyndall Mollart, Jon Adams, Maralyn Foureur
UNLABELLED: Feasibility randomised controlled trials of complementary medicine are important to evaluate acceptability and practicality. This study examined participants' and health professionals' perceptions of CAM and participation in a feasibility RCT of acupressure for labour onset. METHODS: A qualitative study incorporated within an RCT. Data were collected from postnatal women via questionnaires and health professionals via focus groups. RESULTS: Four themes emerged from the women's views: "Using CAM to start labour", "Feeling empowered through action", "Desiring randomisation to acupressure group", and "Welcoming the opportunity to assist in research"...
August 2016: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/27396647/health-related-quality-of-life-in-locally-advanced-and-metastatic-breast-cancer-methodological-and-clinical-issues-in-randomised-controlled-trials
#13
REVIEW
Irina Ghislain, Efstathios Zikos, Corneel Coens, Chantal Quinten, Vasiliki Balta, Konstantinos Tryfonidis, Martine Piccart, Dimitrios Zardavas, Eva Nagele, Vesna Bjelic-Radisic, Fatima Cardoso, Mirjam A G Sprangers, Galina Velikova, Andrew Bottomley
Breast cancer is the leading cause of cancer death among women worldwide, and increasingly, randomised controlled trials of this disease are measuring the health-related quality of life of these patients. In this systematic Review, we assess the adequacy of methods used to report health-related quality of life (HRQOL) from 49 eligible randomised controlled trials of advanced breast cancer. We compare our findings with those from the literature to investigate whether the standard of HRQOL reporting in this field has changed...
July 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27388345/multicountry-survey-of-emergency-and-critical-care-medicine-physicians-fluid-resuscitation-practices-for-adult-patients-with-early-septic-shock
#14
Lauralyn McIntyre, Brian H Rowe, Timothy S Walsh, Alasdair Gray, Yaseen Arabi, Anders Perner, Anthony Gordon, John Marshall, Deborah Cook, Alison Fox-Robichaud, Sean M Bagshaw, Robert Green, Irwin Schweitzer, Alexis Turgeon, Ryan Zarychanski, Shane English, Michaël Chassé, Ian Stiell, Dean Fergusson
OBJECTIVES: Evidence to guide fluid resuscitation evidence in sepsis continues to evolve. We conducted a multicountry survey of emergency and critical care physicians to describe current stated practice and practice variation related to the quantity, rapidity and type of resuscitation fluid administered in early septic shock to inform the design of future septic shock fluid resuscitation trials. METHODS: Using a web-based survey tool, we invited critical care and emergency physicians in Canada, the UK, Scandinavia and Saudi Arabia to complete a self-administered electronic survey...
July 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27062613/knowledge-translation-studies-in-paediatric-emergency-medicine-a-systematic-review-of-the-literature
#15
REVIEW
Catherine L Wilson, David Johnson, Ed Oakley
AIM: Systematic review of knowledge translation studies focused on paediatric emergency care to describe and assess the interventions used in emergency department settings. METHODS: Electronic databases were searched for knowledge translation studies conducted in the emergency department that included the care of children. Two researchers independently reviewed the studies. RESULTS: From 1305 publications identified, 15 studies of varied design were included...
February 2016: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/26822969/the-relationship-between-training-load-and-injury-illness-and-soreness-a-systematic-and-literature-review
#16
REVIEW
Michael K Drew, Caroline F Finch
BACKGROUND: Clinically it is understood that rapid increases in training loads expose an athlete to an increased risk of injury; however, there are no systematic reviews to qualify this statement. OBJECTIVE: The aim of this systematic review was to determine training and competition loads, and the relationship between injury, illness and soreness. METHODS: The MEDLINE, SPORTDiscus, CINAHL and EMBASE databases were searched using a predefined search strategy...
June 2016: Sports Medicine
https://www.readbyqxmd.com/read/26784282/review-article-staff-perception-of-the-emergency-department-working-environment-integrative-review-of-the-literature
#17
REVIEW
Amy Johnston, Louisa Abraham, Jaimi Greenslade, Ogilvie Thom, Eric Carlstrom, Marianne Wallis, Julia Crilly
Employees in EDs report increasing role overload because of critical staff shortages, budgetary cuts and increased patient numbers and acuity. Such overload could compromise staff satisfaction with their working environment. This integrative review identifies, synthesises and evaluates current research around staff perceptions of the working conditions in EDs. A systematic search of relevant databases, using MeSH descriptors ED/EDs, Emergency room/s, ER/s, or A&E coupled with (and) working environment, working condition/s, staff perception/s, as well as reference chaining was conducted...
February 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/26612854/mitochondrial-disease-in-adults-what-s-old-and-what-s-new
#18
REVIEW
Patrick F Chinnery
Ten years ago, there was an emerging view that the molecular basis for adult mitochondrial disorders was largely known and that the clinical phenotypes had been well described. Nothing could have been further from the truth. The establishment of large cohorts of patients has revealed new aspects of the clinical presentation that were not previously appreciated. Over time, this approach is starting to provide an accurate understanding of the natural history of mitochondrial disease in adults. Advances in molecular diagnostics, underpinned by next generation sequencing technology, have identified novel molecular mechanisms...
December 2015: EMBO Molecular Medicine
https://www.readbyqxmd.com/read/26403220/oral-tapentadol-for-cancer-pain
#19
REVIEW
Philip J Wiffen, Sheena Derry, Katrien Naessens, Rae F Bell
BACKGROUND: A large proportion of people with advanced cancer will experience moderate to severe pain. Tapentadol is a novel, centrally acting analgesic medicine acting at the μ-opioid receptor and inhibiting noradrenaline reuptake. The efficacy of tapentadol is stated to be comparable to morphine and oxycodone. OBJECTIVES: To assess the analgesic efficacy of tapentadol for the relief of cancer pain in adults, and the adverse events associated with its use in clinical trials...
September 25, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26377718/emerging-science-in-paediatric-heart-transplantation-donor-allocation-biomarkers-and-the-quest-for-evidence-based-medicine
#20
REVIEW
Kevin P Daly
Heart transplantation offers excellent survival benefit to children with end-stage heart failure. With its success, the number of potential recipients continues to exceed the number of available donors. Developing strategies to safely increase donor utilisation is crucial to decreasing wait-list mortality. A new paediatric heart allocation policy is set to be implemented with the goal of prioritising the most urgent listed candidates. Owing to excellent outcomes of ABO-incompatible heart transplantation, the sickest infants will soon receive priority for heart offers irrespective of blood group...
August 2015: Cardiology in the Young
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